ADHD: Why Can't the Mental Health "Business" Define Normal?

We have a culture which has become obsessed with illness while it often ignores or overlooks wellness…

Image by Alexandr Ivanov from Pixabay

When the patient loves his disease, how unwilling he is to allow a remedy to be applied.
— Pierre Corneille, Le Cid

If you look through the index of the Diagnostic and Statistical Manual of Mental Disorders, often referred to as the DSM, published by the American Psychiatric Association, you will not find the word “normal” listed. This shouldn’t come as a big surprise: the DSM is about psychiatric abnormalities, and the business of the psychiatric and psychological industries is to assist persons with problems.

However, it does point up one overarching reality that extends well beyond just the field of psychiatry: we have a culture which has become obsessed with illness while it often ignores or overlooks wellness.

This has lead to the labeling of many relatively “normal” parts of the human condition as pathologies. In the modern recovery movement, people are often encouraged not to become stronger or resilient but instead to wallow in their weaknesses and to search for villains at which to point the finger of blame. These villains range from parents, to environmental poisons, to “brain abnormalities” such as ADHD.

For many this is merely an easy out, a technique for shifting away personal responsibility. However, the idea that such “weaknesses” or “damage” will automatically cause us to fail is, in fact, not at all consistent with reality.

For example, studies of “at risk” children done over the past 50 years (the most famous one being a study done in Hawaii) show that children from abusive, alcoholic, “broken” and poverty-struck homes are far more likely to grow up as healthy, well-adjusted adults than they are to grow up mentally ill, neurotic, or “damaged.” While many are fragile, many are also highly resilient, often more-so than their peers who grew up in “normal” homes.

How could this be?

Two pioneers in this field, Drs. Stephen and Sybil Wolin, in their book The Resilient Self, posit what they call the “Challenge Model” of childhood development as the answer.

In this view of human development, children use adversity as a tool to develop their own inner strengths and resiliences. While they often emerge into adulthood with scars (virtually everybody does), they also come through this difficult process of growing up with powerful strategies for dealing with adversity. In fact, these children are often far more successful and adaptive as adults than are the children of “normal” families.

Unfortunately, the Challenge Model is not known to most people, whereas the idea that people are damaged irreparably by their negative childhood experiences has so thoroughly infiltrated our popular media and the public’s notions of psychology that it’s considered an irrefutable truth.

This glorification of frailty has led us to both trivialize serious mental illnesses, and to view substantial parts of the what was once called “human nature” as neatly organized little disease categories. Wendy Kaminer in her book “I’m Dysfunctional, You’re Dysfunctional,” points this out with excruciating insight.

She shows how an advertising-hungry media and a run-amok victimness movement have shifted our view from an appropriate analysis of human differences into a hysterical search for our own particular mental illnesses, weaknesses, or category of victim status.

The upshot of this is the explosion of fads, books, and recovery groups, along with the apparent desire of just about every good citizen to figure out which particular mental illness they are suffering from.

“You Americans astound me,” Dr. Oswain Gierth of Germany told me a few years ago. “You spend so much time looking at and for behaviors and conditions that you can create labels and treatments for. Much of what you call ADHD over there, here in Germany we would just call part of the spectrum of human behavior.”

It’s reached the point where when I speak at ADHD support groups, the majority of people who want to talk with me after my speech are anxious to proclaim their own ADHD, as if it were a badge of honor to have a DSM-certified mental-illness label. While I’m proud that I’m a “Hunter” at heart, I would be reluctant to brag to anybody that I have a mental illness or “disorder.”

Much of this is fueled by the flood of books, magazine articles, and TV talk-shows which wallow and revel in emotional and mental pain, illness, and victimhood. Rarely do such media ever portray the wonders of resilience, or mention that over 70% of the children of severe alcoholics grow up with no alcohol problem (although they are more at risk), or tell us that the majority of people who suffered severe abuse as children are quite functional as adults, thank you very much.

By buying into the notion that a person is “damaged goods” because he or she had a painful childhood or is neurologically off the norm, we disempower that individual. We imply to them that they’ll never be successful without our (often expensive) help, that they’re lacking in inner resources, and that they’re fundamentally flawed. This can cause a person to become locked into a lifelong cycle of victimness which, while obsessing on their weaknesses, never gives them an opportunity to develop or use their own internal strengths.

And yet, research shows clearly that it’s often these very life-pains and neurological differences themselves which can be a source of strength when reframed and viewed in a positive light.

An article in The Journal of Learning Disabilities sought to identify those patterns of behavior or thought which had helped adults with learning disabilities to be successes instead of failures. The single most important variable, they found, was the degree to which the people viewed their disabilities in a positive light, rather than in a negative way. Those people who saw themselves as damaged goods were measurably less likely to be successful than equally “disabled” adults who instead viewed their differences as unique creativities or eccentricities.

Similarly, in the Hawaii studies, it was found that those children who viewed their abusers or painful life situations as adversities to overcome were most likely to be resilient and emotionally strong as adults. They often grew up successful and highly functional, in sharp contrast to their equally-abused or poverty-stricken peers who passively surrendered themselves to the situation and then, as adults, failed and blamed their failures on their past, on others, or on themselves.

Unfortunately, the majority of our media and spokespeople for the “helping professions” rarely encourage people to view their adversities and challenges in a positive light. Instead, there’s a stampede on to join the victim-of-the-month club.

In this frantic search for victimness, the ADHD label is a convenient one for many people. In many cases this is because whatever it is that we call ADHD really is a problem. But in many other cases, it’s the search for a scapegoat, an excuse, or even a reason to identify with a group to gain social acceptance. In some circles it’s now as “in” to have ADHD as it was to have Chronic Fatigue Syndrome thirty years ago.

And so, myth or not, seriously afflicted or not, many people are pinning the badge of ADHD upon themselves and their children, swept up in the tide of this latest darling of pop psychology. Unfortunately, instead of looking for possible ways to work through or around ADHD, many in the recovery movement (which the ADHD support movement has sometimes morphed into) focus entirely on “brain abnormalities,” “co-morbidities,” and the latest medication.

Solutions

There are potential dangers for people with ADHD in the recovery movement that’s sprung up around this label. Most in it are well-intentioned, honest, and very helpful people: many lives are being improved and people saved from failure and disaster.

But there are also shameless self-promoters with over¬priced books and videotapes, or who organize “support groups” only to exercise personal power over others, or label others as sick only because they can then sell them a palliative (some even involving exposures to radiation or experimental drugs, in a fashion painfully reminiscent of the radium treatments children were routinely given in the 1950’s which led to an explosion of thyroid and other cancers in later life).

And so the ADHD movement grows, more are swept into it, and pretty soon the backlash comes with people calling ADHD a myth, a made-up category, and a non-disease.

Of course the backlash folks are as wrong as are the “half the population has ADHD” promoters. The reasonable middle-ground is that there is such a thing—or things—as ADD/ADHD, but that much of the hysteria and hype surrounding it is misplaced or in-place only to serve special interests.

We must seek a rational middle ground, acknowledge and nurture the often-considerable strengths to be found in ADHD “Hunter” individuals, and help them bring these out and develop them as life skills. And we must be very careful of the fad-of-the-month syndrome, and those who would offer instant remedies or “for your own good” hand-holding.